Health News

Health Highlights: Aug. 12, 2013

Health Highlights: Aug. 12, 2013

08/12/13

Here are some of the latest health and medical news
developments, compiled by the editors of HealthDay:

Foreign Trained Doctors Could Ease U.S. Physician Shortage:
Advocates

The United States has thousands of foreign-trained immigrant
doctors whose valuable skills go unused due to the highly demanding
requirements they need to fulfill in order to get their license to
practice here.

There is a shortage of doctors in many parts of the country and
it is expected to get worse when millions more Americans get health
care insurance in 2014 as part of the new health care law,
The New York Timesreported.

It said that the challenging testing and often duplicative
training that foreign doctors must complete are meant to ensure
they meet the United States' high quality standards.

However, many foreign doctors and their supporters say the
process is unnecessarily restrictive and time-consuming. They also
contend that these restrictions are one reason why health care
services in the U.S. cost far more than in other countries,
The Timesreported.

Advocates say that the country needs to take advantage of the
skills of foreign-trained doctors. They point to Canada's efforts
to recognize high-quality medical training programs in other
countries.

"It doesn't cost the taxpayers a penny because these doctors come fully trained," Nyapati Raghu Rao, the Indian-born chairman of psychiatry at Nassau University Medical Center and a past chairman of the American Medical Association's international medical graduates governing council, told The Times.

"It is doubtful that the U.S. can respond to the massive shortages without the participation of international medical graduates. But we're basically ignoring them in this discussion and I don't know why that is," Rao said.

The U.S. has long been training too few doctors to meet its
needs, partly due to industry-set limits on the number of medical
school spaces available. About 25 percent of doctors in the U.S.
were trained in other countries, including a significant number of
American citizens who could not get into a U.S. medical school,
The Timesreported.

Arguments against allowing foreign-trained doctors to practice
in the U.S. include concerns about quality and that doing so will
draw more doctors from poor countries, leaving those nations with
doctor shortages.

"We need to wean ourselves from our extraordinary dependence on importing doctors from the developing world," said Fitzhugh Mullan, a professor of medicine and health policy at George Washington University in Washington, told The Times.

"We can't tell other countries to nail their doctors' feet to the ground at home. People will want to move and they should be able to. But we have created a huge, wide, open market by undertraining here, and the developing world responds," he said.

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Use of Antipsychotics in Children Under Investigation by HHS

An investigation into whether certain antipsychotic drugs are
being prescribed too often to treat behavioral problems in
youngsters covered by Medicaid is being conducted by federal health
officials.

The review has been underway for several months and is being
conducted by the inspector general's office at the Department of
Health and Human Services. In a parallel move, various agencies
within HHS are telling state officials to tighten oversight of
prescriptions of such drugs to Medicaid recipients who are 17 and
younger, the
Wall Street Journalreported.

The focus is on a class of antipsychotic drugs called
"atypicals," which include brand names drugs such as Abilify,
Risperdal, Seroquel and Zyprexa. This class of drugs was originally
developed to treat psychoses such as schizophrenia, but some were
later approved by the Food and Drug Administration to treat
children with conditions such as bipolar disorder and
autism-associated irritability.

Federal health officials want to reduce "the unnecessarily high
utilization of antipsychotics," according to Dr. Stephen Cha, a
chief medical officer at the Centers for Medicare & Medicaid
Services,
WSJreported.

Doctors need to consider other approaches, including therapy, to
help children and families cope with psychological trauma that
could be the cause of behavior issues, Cha said.

Medicaid spent $3.6 billion on antipsychotic medications in
2008, compared with $1.65 billion in 1999, according to an analysis
by Washington, D.C.-based Mathematica Policy Research. That
increase occurred even though pharmacy benefits for millions of
Medicaid patients were shifted to Medicare in 2006,
WSJreported.

The number of people under age 20 receiving Medicaid-funded
prescriptions for antipsychotic drugs tripled between 1999 and
2008, the Mathematica analysis found.

Children on Medicaid are prescribed antipsychotics at four times
the rate of privately insured children, according to a study that
examined 2004 data from 6- to 17-year-old children in seven states.
The study was conducted by Stephen Crystal, a professor of health
policy at Rutgers University,
WSJreported.

The HHS probe focuses on the five largest Medicaid states:
California, Florida, Illinois, New York and Texas and covers a
six-month period from January to June 2011. During that time,
84,654 children 17 and younger in those states were prescribed
antipsychotics paid for by Medicaid. About 700 of those cases will
be analyzed by pediatric psychiatrists.

"Through medical-record reviews, we will determine whether these prescriptions were medically indicated, and whether taxpayers were being billed for inappropriate, poor-quality care," said HHS Inspector General Daniel Levinson, WSJreported.

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All Sterile Products From Texas Company Recalled: FDA

A nationwide recall of all sterile products from a Texas company
called Specialty Compounding was announced by the U.S. Food and
Drug Administration.

The recall was prompted by 15 reports from two Texas hospitals
of bacterial bloodstream infections potentially linked to the
company's calcium gluconate infusions.

All sterile products made and distributed by Specialty
Compounding are being recalled and none of these products should be
given to, or used by, patients. Health facilities, health care
providers and patients who have received the products since May 9,
2013 should immediately stop using the products, quarantine them
and return them to Specialty Compounding, according to the FDA.

"The FDA believes that use of these products would create an unacceptable risk for patients," Dr. Janet Woodcock, director of FDA's Center for Drug Evaluation and Research, said in an agency news release. "Giving a patient a contaminated injectable drug could result in a life-threatening infection."

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Autism May be Linked to Cancer-Causing Gene Mutations

Certain gene mutations that cause cancer or tumors appear to be
linked with autism in some people, according to researchers.

They found that 10 percent of children with mutations in a gene
called PTEN -- which causes breast, colon, thyroid and other organ
cancers -- have autism. So do about half of children with gene
mutations associated with some forms of brain and kidney cancer,
and large tumors in the brain and some other organs,
The New York Timesreported.

That is much higher than the autism rate in the general
population. But scientists note that the findings apply to only a
small percentage of people with autism.

The discovery of a possible link between cancer-causing gene
mutations and autism has enabled researchers to genetically
engineer mice with many autism symptoms, and has also led to the
first clinical trial of a treatment for children with autism. The
trial is testing a drug used to treat tumors with the same genetic
basis,
The Timesreported.

Many scientists who had no role in the research linking autism
and cancer-causing gene mutations say the work is changing their
understanding of autism and why it develops.

The parallels between cancer and autism are "quite uncanny,"
according to Jonathan Sebat, chief of the Center for Molecular
Genomics of Neuropsychiatric Diseases at the University of
California, San Diego.

"We haven't solved it all; we have only solved a tiny bit. But the small bit we solved has been very illuminating," he told The Times.

But others question the findings. Autistic children with the
cancer gene mutations have "a brain that is failing in many ways"
and autism in these children could be due to general brain
malfunction, according to Harvard University geneticist Steven
McCarroll.

"The fact that autism is one of the many neurological problems that arise in these patients doesn't necessarily tell us anything penetrating about the social and language deficits that are specific to autism," he told The Times.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.